State considering how to increase hospital transparency
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Recent reports that underscore persistent variations in health care prices charged by different Massachusetts hospitals have led to renewed calls for greater transparency around what patients pay for medical services.
The goal is to create smarter shoppers and help contain health care costs. But even as the push for more and better information about medical prices intensifies, the state has yet to enforce existing laws designed to address the issue.
In the landmark health care reform law of 2006, and again in 2012, the Legislature approved language that required the state to establish a website with information about health care cost and quality. It was meant to be a user-friendly guide for consumers trying to find the most affordable and high-quality place to get an MRI, a colonoscopy, or another common procedure.
The state agency in charge of launching the website, however, hasn't figured out how to do that yet. The Center for Health Information and Analysis, or CHIA, is still in the process of determining exactly what kind of health care information consumers really need, said Aron Boros, executive director of the agency.
CHIA doesn't want to duplicate the efforts of insurers or other organizations that already publish cost information, he said. A new website is expected to cost the state at least $1 million, but could cost much more depending on how detailed it is.
"The principle reason there's been a delay is we're trying to be a careful steward of the taxpayer's money and make sure we're [addressing transparency] in a way that is actually valuable for patients and families," Boros said. "We are absolutely committed to some investment in consumer transparency. I don't know what that looks like."
The Health Policy Commission, another state agency, reported last week that the price of medical services continues to vary widely among health care providers, even when the quality of care is not significantly different. That trend threatens to drive overall health care spending higher statewide, because the priciest health systems, such as Partners HealthCare of Boston, also treat the most patients.
The price disparities are evident in one common medical service, maternity care for low-risk pregnancies, where spending can range from $9,722 at one hospital to almost twice that, $18,475, at another, the Health Policy Commission said.
The commission called for greater transparency around health care costs, echoing calls by Governor Charlie Baker and consumer advocates such as the group Health Care for All. But it's unclear when or how state officials will tackle the issue. Boros said his agency will work to develop a timeline for the project over the next six months.
Baker spokeswoman Lizzy Guyton said, "The administration is working collaboratively with the Center for Health Information and Analysis to develop a useful website that increases the amount of health care data available to consumers."
The effort to create a state health care cost website dates back to the Romney administration, when state officials launched a rudimentary site in 2005. Massachusetts' landmark health care reform law passed the following year, requiring the development of a new website. The site launched in 2008 and continued in some form until 2015, when it was shut down because it was poorly used and CHIA decided it was no longer useful to consumers.
About the same time, insurers launched their own websites with cost information, a requirement of the 2012 state health care law. These sites give detailed information about the costs of different medical procedures at different health care facilities, but they're accessible only to members of a particular insurer. For example, a Harvard Pilgrim Health Care member can review costs only through the Harvard Pilgrim website.
But these sites are not yet widely used, with some of them getting only a few hundred clicks a month. "Consumers aren't usually aware these websites exist," said Alyssa Vangeli, senior health policy manager of Health Care for All.
It's crucial for the state to establish its own website so consumers have a "one-stop shop" to make it easier to review information about how much it will cost them to get medical care, Vangeli said: "Much more needs to be done."
The Massachusetts Association of Health Plans, which represents the insurance industry, also supports a state-run website. "Having an independent, third party to do that helps to validate the information out there around price and quality," said Eric Linzer, vice president of the association.
The Massachusetts Hospital Association, a trade group, said a state website could be a useful tool but warned that creating a the site would be "an extremely complex undertaking."
"Such a website would need to ensure that listed prices were both accurate and up-to-date," Lynn Nicholas, chief executive of the association, said in an e-mail. "Most importantly, any website displaying cost information must also include clear links to relevant quality measures."